Individual
PATRICK EUGENE LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-7595
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-7595
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
38646
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
38646
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18578
PARTNERS
—
01
—
50669
BCBS
NC
01
—
64245
MEDCOST
NC
05
—
6601481
—
VA
01
—
7675356
AETNA
—
05
—
8950669
—
NC
05
—
Q38646
—
SC
Enumeration date
12/02/2005
Last updated
08/20/2010
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